Overview

The UBC Department of Psychiatry and UBC CPD are hosting a two-day intensive review of ASD in adults that will:

Provide attendees with the knowledge they need to diagnose adults who do not also have intellectual disabilities

Review common obstacles for adults with ASD and present appropriate interventions for maximizing developmental progress

Teaching will be supplemented by video clips of affected individuals to illustrate particular aspects of psychopathology and also by panels of individuals diagnosed in adult life who will be able to take questions from the audience

** THIS EVENT WILL ALSO BE WEBCAST **

Agenda

Friday February 1

The overall goal of this day is to provide attendees with the knowledge they need to be able to diagnose Autism Spectrum Disorders in adults who do not also have intellectual disability. The didactic teaching will be supplemented by video clips of affected individuals to illustrate particular aspects of psychopathology and also by a panel presentation by individuals diagnosed in adult life who will be able to take questions from the audience.

0800 Breakfast & Registration

0900 Introduction to ASD in AdultsThis presentation will summarise the relevant key points of our current knowledge about ASDs with respect to aetiology, neurobiology, cognitive and emotional abnormalities, comorbid conditions, changes in diagnostic practise and the use of screeners, gender differences in presentation and factors leading to delayed diagnosis.
Learning Objectives:

ASDs are common disorders whose diagnosis may be delayed until adult life when unaccompanied by intellectual disability.

Presentation in adult life is very variable and can also differ by sex/gender.

Diagnosis is important for adjustment, optimising the individual’s developmental trajectory, identifying common comorbidities and maximising quality of life.

1000 Refreshment Break

1030 Developmental History & Current BehaviorsThis presentation will focus on diagnostically useful information that can be obtained from an informant preferably a parent or childhood caregiver. Many behaviors that are useful pointers to an ASD diagnosis may only occur in childhood and need to be asked about directly. Additionally, some behaviors particularly those in the repetitive and stereotyped domain may not be observable in a clinic setting and so current collateral information is required.
Learning Objectives:

Some behaviors that are useful clues to the diagnosis of ASD may only be observed early in development and so accurate diagnosis requires obtaining a focussed developmental history from a parent or childhood caregiver.

Questioning should cover a broad range of diagnostically useful behaviors in the domains of social reciprocity, social communication and repetitive and stereotyped behaviors, as accurate diagnosis is based upon a pattern of behaviors rather than the presence or absence of a pathognomonic behavior.

Information about current functioning is required from an informant as not all diagnostically useful behaviors may be observed in a clinic.

1230 Lunch (provided)

1315 Observational & Interactive AssessmentIn addition to obtaining a developmental and current history from an informant, relevant self-reported symptomatology and observable behaviors in keeping with ASD are important for diagnosis. The issue is complicated by the tendency for affected individuals to acquire compensatory strategies that can disguise some impairments, and by the fact that a traditional mental state examination is not optimised to reveal deficits in reciprocal social interaction and communication. This presentation will provide examples of diagnostically useful ASD behaviors that can be reported or observed in a clinic setting and provide advice on how to elicit these features.
Learning Objectives:

A traditional question and answer style mental state examination is not optimised for detecting abnormalities in reciprocal social communication and the assessment process must be modified when ASD is suspected.

A face to face interaction offers an opportunity to ask about school, employment and independent living as well as the individual’s personal experience of different emotional states and relationships

Signs of ASD can vary within an assessment session and more weight should be given to whether they are observed at all than to whether they are present consistently. Dr. Anthony J. Bailey

1445 Refreshment Break

1515 Differential Diagnosis & InvestigationsUsually the diagnosis of ASD in adult life is relatively straight forward providing an appropriate developmental history is obtained and relevant signs are observed. Difficulties may be encountered when a developmental history is not available or when there are also significant co-morbid psychiatric disorders. Further investigations depend greatly on the presentation and the difficulties that the individual is facing in their current life.
Learning Objectives:

Neurodevelopmental disorders tend to co-occur and many individuals with ASD will have had symptoms of ADHD when younger, which may have persisted.

If the individual is currently experiencing significant symptoms from a major psychiatric disorder an assessment for ASD should be delayed.

Psychometric or psychovocational evaluations can be helpful when there was no testing in childhood or there is a chequered work history that is not attributable to difficulties with social interaction.

1545 Panel Presentation by Adults with ASD & QuestionsThree or four individuals diagnosed with ASD in adult life will each give a brief description of their lives before receiving a diagnosis and then describe the impact of receiving a diagnosis. The panel will then take questions from the audience. Audience to complete feedback forms.

Saturday February 2

The overall goal of this day is to provide attendees with information about the key issues that affect ASD adults who do not have intellectual disabilities and appropriate interventions. The focus will be on common obstacles in everyday life and maximising developmental progress. The presentations will include video of adults describing common difficulties and the day will end with a panel presentation by adults followed by questions from the audience.

0830 Breakfast & Registration

0900 Introduction to Management of Able Adults with ASDAdults with ASD face multiple challenges including high rates of co-morbid psychiatric disorders, suboptimal progress through higher education and poor employment prospects, difficulties with relationships and difficulties transitioning to independence in adulthood. Many of these difficulties can be ameliorated with appropriate interventions, but optimising progress usually requires setting clear priorities.
Learning Objectives:

Research data suggest that outcome for adults with ASD is often suboptimal and there are still many gaps in service provision.

Adults with ASD often face multiple simultaneous challenges, but a high treatment priority is to identify and treat any comorbid psychiatric disorders.

The overall goals of management are to improve quality of life, and to maximise independence skills in a timely fashion y

1000 Refreshment Break

1030 Diagnosing and Managing Co-morbid DisordersOver the last 10 or so years we have become increasingly aware that adults with ASD experience very high rates of co-morbid psychiatric disorders, which often cause as much or more impairment than the core disorder. Nevertheless, many aspects of ASD can delay the recognition of co-morbidities. Overall, treatments that are effective in the general population seem also to be efficacious in adults with ASD, although sometimes psychological interventions may need some modification.
Learning Objectives:

Comorbid psychiatric disorders are very common in adults with ASD, particularly anxiety, but some individuals may be poor at recognising relevant symptoms.

Some psychiatric symptoms are exacerbated by lack of routine and structure and these environmental factors should not be overlooked in management

Some patients may be inflexible when considering treatment options and the capacity to take a long-term view is an important aspect of management

1230 Lunch (provided)

1315 Optimising Higher Education, Work and IndependenceWorldwide, progress in higher education and employment rates for adults with ASD are both poor and many individuals fail to achieve independence. Institutes of higher education have gotten better at supporting affected individuals but transitioning into employment remains a systemic weakness. Success in employment is often predated by voluntary work experience and job coaches may be available, although overall employment support remains very limited. Overall, very few resources are available in the community for adults without ID and families still remain a bedrock for many individuals.
Learning Objectives:

Many adults with ASD can succeed in higher education and the workplace, but careful planning and preparation increase the chances of success and progress may initially be slower than in the typically developing population.

The major worry for parents is how their offspring will support themselves and live independently in the future and addressing those concerns usually requires a focus on the acquisition of specific skills.

Low rates of employment are a major obstacle to independence and contribute to low self-esteem.

1445 Refreshment Break

1515 Panel Presentation by Adults with ASD & QuestionsThree or four individuals with ASD will give descriptions of their experiences with higher education, employment, dealing with psychiatric comorbidity and parenting. The panel will then take questions from the audience.
1615 Wrap up and future support and mentorshipThe key points of management will be summarised and opportunities for support and mentorship in managing adults with ASD will be reviewed. Audience to complete feedback forms.

Cost

*No refunds or transfers, unless you cancel IN WRITING by Jan 7, 2019 for a fee of $50. Registrations are not accepted fewer than 4 days before the conference start date. Please contact our office at cpd.info@ubc.ca regarding the availability of on-site registration.

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